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Thrombophilias and adverse pregnancy outcome - A confounded problem!

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dc.contributor.authorKist, W.
dc.contributor.authorJanssen, N.
dc.contributor.authorKalk, J.
dc.contributor.authorHague, W.
dc.contributor.authorDekker, G.
dc.contributor.authorde Vries, J.
dc.date.issued2008
dc.description.abstractIt was the objective of this study to analyse the influence of confounders, such as ethnicity,severity of illness and method of testing, in articles concerning the still moot relationship of thrombophilias to adverse pregnancy outcome (APO). Relevant casecontrol studies were identified using Medline and EMBASE databases between 1966 and 2006. Search terms were recurrent fetal loss, intrauterine fetal death, preeclampsia, HELLP-syndrome, eclampsia, fetal growth restriction, abruptio placentae, combined with maternal thrombophilias. Data was extracted from the articles per subgroup ofAPO regardless of confounder. These subgroups were tested if they fulfilled the heterogeneity testing criterion (I2 > 35%) to weigh the influence of the confounder. Confounders were selected and examined with Mantel- Haenszel method. Increased thrombophilia prevalence was confirmed in most adverse pregnancy outcomes. Ethnicity, genetic testing only and severity of illness were confounders in the various forms of APO. Stronger relationships between factor V Leiden and severity of disease were found in 2nd and 3rd trimester than 1st trimester recurrent fetal loss, in preeclampsia with: blood pressure ≥160/110 mmHg than ≥140/90 mmHg; proteinuria ≥5 grams per day than < 5 grams; onset before than after 28 weeks, in fetal growth restriction <3rd percentile than <5th, than <10th, and in earlier occurrence of abruptio placentae than 3rd trimester. In conclusion, reports on the prevalence of maternal thrombophilias and APO are influenced by various confounders, which are not always appropriately analysed.The differences we have identified reflect the differential impact of these confounders. These data emphasise the importance of more uniform research.
dc.description.statementofresponsibilityWillem J. Kist, Nard G. Janssen, Jakoba J. Kalk, William M. Hague, Gustaaf A. Dekker, Johanna I. P. de Vries
dc.identifier.citationThrombosis and Haemostasis, 2008; 99(1):77-85
dc.identifier.doi10.1160/TH07-05-0373
dc.identifier.issn0340-6245
dc.identifier.issn2567-689X
dc.identifier.orcidHague, W. [0000-0002-5355-2955]
dc.identifier.orcidDekker, G. [0000-0002-7362-6683]
dc.identifier.urihttp://hdl.handle.net/2440/52286
dc.language.isoen
dc.publisherSchattauer GMBH-Verlag Medizin Naturwissenschaften
dc.source.urihttps://doi.org/10.1160/th07-05-0373
dc.subjectHumans
dc.subjectAbortion, Habitual
dc.subjectFetal Growth Retardation
dc.subjectAbruptio Placentae
dc.subjectPregnancy Complications, Hematologic
dc.subjectThrombophilia
dc.subjectGenetic Predisposition to Disease
dc.subjectPregnancy Outcome
dc.subjectSeverity of Illness Index
dc.subjectPrevalence
dc.subjectRisk Factors
dc.subjectCase-Control Studies
dc.subjectEpidemiologic Research Design
dc.subjectReproducibility of Results
dc.subjectPregnancy
dc.subjectGenotype
dc.subjectPhenotype
dc.subjectFemale
dc.subjectGenetic Testing
dc.subjectConfounding Factors, Epidemiologic
dc.titleThrombophilias and adverse pregnancy outcome - A confounded problem!
dc.typeJournal article
pubs.publication-statusPublished

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